Provider Demographics
NPI:1225219280
Name:KAYASTHA, DINESH B
Entity Type:Individual
Prefix:
First Name:DINESH
Middle Name:B
Last Name:KAYASTHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-8501
Mailing Address - Country:US
Mailing Address - Phone:212-677-7335
Mailing Address - Fax:212-677-7244
Practice Address - Street 1:360 E 4TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-8501
Practice Address - Country:US
Practice Address - Phone:212-677-7335
Practice Address - Fax:212-677-7244
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY29890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist